Permit C I TY OF TIGARD ELECTRICAL PERMIT -
RESTRICTED ENERGY
, DEVELOPMENT SERVICES PERMIT #: ELR2001 -00265
;4
^ 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/25/01
SITE ADDRESS: 15865 SW 74TH AVE 110 PARCEL: 2S112DC 01400
SUBDIVISION: CREEKVIEW INDUSTRIAL PARK ZONING: I -P
BLOCK: LOT: 004 JURISDICTION: TIG
Project Description: Tenant Improvement - Data & Voice
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: X . NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: HVAC: PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER: •
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
PACIFIC AMERICAN PROPERTY EXCH GREENLINE INC
PACIFIC SANTA FE CORP PO BOX 230755
17700 SW UPPER BOONES FERRY RD TIGARD, OR 97223
PORTLAND, OR 97224
Phone: Phone: 968 -1978
Reg #: LIC 103033
ELE 34 -397CL
FEES Required Inspections
Type By Date Amount Receipt Ceiling Cover
PRMT CTR 10/25/01 $75.00 2720010000 Wall Cover
Elect'I Final
5PCT CTR 10/25/01 $6.00 2720010000
Total $81.00
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 through OAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -1987.
Issued by Y .j �-� Permittee Signature '
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale. lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 639 -4175 by 7:00 P.M. for an inspection needed the next business day
r =,�OCT -24 -2001 11:42 GREENLINE, INC. 503 968 2858 P.02 /83
Electrical Permit Appl
- Date received: Permit no.: , 00 / _ 00
b� i1— City of Tigard Project/appl. no.: Expire date:
CitycitTigard Address: 13125 SW Hall Blvd, Tigard, OR 97223 Date issued: Receipt no.:
Phone: (503) 639 - 4171
Fax: (503) 598 Case file no,: Payment type:
Land use approval:
, - TYPE ,01 1 R M I'h .
• 0 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi- family Cl Tenant improvement
0 New construction 0 Addition /alteration/replacement 0 Other: , , U Partial
• JOB S11L'1 INFORMATION .
Job address: ) . , 51 1 7 1 1 141 ,/{-yam Bldg. no.: pp Suite no.: Tax map/tax lot/account no.:
Lot: Block: Subdivision:
Project name: 81A • JM &v. , , Description and location of work on premises: b A A • •
Estimated date of completion/inspection:
C:O ' ;. , . ._ F['1- SCREW'.LE
Job no: nix
Business name:
Descrl HOG Qty. rgl Total no. imp e a
New residential -Angkor multi-family Per
Address: 0 A dwelling unit Includes attached garage.
IBIE i State: Q ZIP: 11& Serviceincluded:
Phone: 50 . , :,_/.9 Fax: 9t' - p ,, E -mail: 1000 sq. ft. or less 4
Each additional 500 sq_ ft. or portion thereof � -
CCB no.: /p p l le.c bus_ I1C no: _ • Limited energy, residential _NM 2
City /metro lie. no.: Limited energy, non- residential —__ 2
��lLI /D— �L,.�/ Each manufactured home or modular dwelling ■■ ■
Signature . supervisin ' i +t (.•d ed) Date Service and/or feeder 2
III
Sup. elect namc(print): �r Servicesorfeeders– installation,
alteration or relocation:
1'llt(.)1'1 al'k' 'OWNER ' ° ' ,. 2 00 amps or less 2
Name (punt): 201 amps to 400 amps MEM_ 2
401 amps to 600 amps =IIIIIII MEM.
Mailing address: 601 amps to 1000 amps In__
City: State: ZIP: Over 1000 amps or volts _INN _ 2
Phone: Fax: E -mail: Reconnect only • ii � 1
Owner installation: The installation is tieing made on property I own or .
which is not intended for sale, lease, rent, or exchange according to insfallation, alter tlayorretoeation:
200 amps or less 2
ORS 447, 455, 479, 670, 701.
201 amps to 400 amps 2
Owner's signature: _ Date: 401 to 600 am.s IIIIIIIM 2
. ' ! ENGINEER ' ,
- Branch circuits - new, alteration,
or extension per panel:
Name: • A. Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit 2
City: State: ZIP: B. Fee for branch circuits Without purchase
of service or feeder fee. first branch circuit; 2
Phone: Fax: E-mail:
■ ��
Eder additional branch circuit: INIIIIIIIIIIIIM
PLAN RI VI (Please. all Ihtt apply) • Misc. (Service or feeder not included):
0 Service over225 amps- commercial El Health-care facility Each pump or litigation circle 2
❑ Service over 320 amps -ruling of 1&2 0 Hazardous location Each sign or outline lighting 1E11E10 _ 2
family dwellings 1"] Building over 10,000 square feet four or Signal circuit(s) or limited energy panel, ■■ �
0 System over 600 volts nominal more residential units in one structure alteration, or extension' 2
❑ Building over three stories 0 Feeders, 400 amps or more *Description_
❑ Occupant load over 99 persons 0 Manufactured structures or RV park Each additional inspection over the allowahlc in any of the above:
❑ Egress/lightingplan ' U Other: Per inspection Ei li=1
Submit sets of plans with any of the above. Investigation fee
The above are not applicable to temporary construction service. Other •
Permit fee $ 2 o( —
'Not an jurladiatioax accept etedit cords, please enit jutit:diction fa more inforrnation) Noticc: This permit application Plan rC fe (at _ %)
b4Visa 0 MasterCard sane expires if a permit is not obtained
Credit card number; .4Z4 - q7/ 0= 0012,6' within 180 days after it has been State surcharge (8%) .... $ . S ��
rf(y r - r_'pir 7 accepted as complete. TOTAL $ ,
Na of 01 at shown on credit card $ Q j 6-)a
Cardholder xignarure Amount i 4404615 (G/00/COM)
.- 1 , OCT -24 -2001 1 42 GREENLINE, INC. 503 968 2058 P.03 /03
ELECTRICAL PERMIT FEES: LIMITED ENERGY PERMIT FEES:
Com 1 Fee Schedule Below: TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
(J Restricted Energy Fee $75.00
Number of Inspectionszr permit allowed (FOR ALL SYSTEMS)
Service included: Items Cost Total Check Type of Work Involved
Residential - per unit
1000 sq. ft. or less $145.15 4 ❑ Audio and Stereo Systems"
Each additional 500 sq. ft. or
portion thereof $33.40 1 ❑ Burglar Alarm
Limited Energy $75.00
Each Manufd Home or Modular 111 Garage Door Opener
Dwelling Service or Feeder $90,90 2
Services or Feeders ❑ Heating, Ventilation and Air Conditioning System'
installation, alteration, or relocation
200 amps or Tess $80.30 2
201 amps to 400 amps $106.85 2 n Vacuum Systems
401 amps to 600 amps $160.60 2
601 amps to 1000 amps $240.60 2 ri Other
Over 1000 amps or volts $454.65 2
Reconnect only $66.85 2
Temporary Services or Feeders TYPE OF WORK INVOLVED - COMMERCIAL ONLY
Installation, alteration, or relocation Fee for each system $75.00
200 amps or less $66.85 2 (SEE OAR 918- 260 -260)
201 amps to 400 amps $100.30 2
• 401 amps to 600 amps $133.75 2 Check Type of Work Involved:
Over 600 amps to 1000 volts, ❑
see "b" above. Audio and Stereo Systems
Branch Circuits Boiler Controls
New, alteration or extension per panel
a) The fee for branch circuits
WWI purchase of service or n Clock Systems
feeder fee,
Each branch circuit $6.65 2 ® Data Telecommunication installation
b) The fee for branch circuits
without purchase ofserv/ce ❑ Fire Alarm Installation
or feeder fee.
First branch circuit . $46.85
Each additional branch circuit $6.65 ❑ HVAC
miscellaneous n Instrumentation
(Service or feeder not included)
Each pump or irrigation circle $53.40 l l intercom and Paging Systems
E ach sign or outline lighting $53.40 -
Signal cireult s or a limited ener gy
panel, alteration or extension $75.00 ❑ Landscape Irrigation Control"
Minor Labels (10) $125.00
Each additional inspection over ❑ Medical
the allowable in any of the above
per inspection $62.50 ❑ Nurse Calks
Per hour $62.50
In Plant $73.75 n Outdoor Landscape Lighting'
Pees: ❑ Protective Signaling
Enter total of above fees $ ❑ Other
8% State Surcharge $ Number of Systems
25% Plan Review Fee
See "Plan Review - section on $ " No licenses are required. Licenses are required for all other installations
front of application. —
Fees:
Total Balance Due $ oD
Enter total of above fees S 7a •
❑ Trust Account # 8' /e State Surcharge $ " , 00
Total Balance Due $ .
a(, oD
All New Commercial Buildings require 2 sots of plans.
1: \dsts \forms \elc- fees.doe OS /30/01
TOTAL P.03
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST_
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested / ( AM PM BLD
Location / 5 ?a 5 7 / i» Lau MEC
Contact Person Ph 1 2-3( 7 PLM _
V
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR 46o1
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing /--0411 L'U G —
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final /
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
F choW' f
ire Alarm
PART FAIL
SITE -
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
Fire Supply Line
ADA / /0/ Approach /Sidewalk Date / / /0/ Inspector �LU (f j Ext
Other �
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.